We propose to study the reasons for raised insulin resistance in childhood obesity by utilizing glucose tolerance testing and constant infusion glucose techniques to set up steady state conditions in glucose and insulin and observe modifying variables. We will continue using the infusion techniques to assess true glucose production in normal and obese states, and will also utilize pulse labeling methods. Computer modeling techniques in collaboration with the National Center for Toxicological Research will allow us to calculate glucose production rates under conditions analogous to steady state isotope infusions. We will continue studies in better methods for body composition with added expertise from Dr. Donald Hill. We will expand even further our work with the nonradiactive labeled glucose as well as develop techniques for hepatic production of the autonomic nervous system. Observation of effects on gastrointestinal hormones and the overall role of the parasympathetic central nervous system in insulin release and glucose utilization will be implemented as well.